BEAUTY REHAB AND CLIENT AGREEMENT
This Beauty Rehab and Client Agreement (“Agreement”) is made between Beauty Rehab, LLC (“Beauty Rehab” or “We” or “Us”), and You (“You” or “Client” or “Your”). Beauty Rehab offers certain nursing aesthetic services in exchange for certain fees paid by You. Included in this Agreement are Your Rights and Our Responsibilities with regard to Your privacy, and Our Client Financial Responsibility, Cancellation and No-Show terms, conditions, and policies.
Please review this Agreement carefully and ask any questions that you may have.
General Consent to Treat. Beauty Rehab offers various nursing aesthetic and other non-nursing aesthetic services. You acknowledge and agree that We may administer and perform services which may include but are not limited to the following: anesthetics, pure platelet growth factor (PDGF), advance laser technologies, dermal fillers, neurotoxins, and weight loss treatments, and blood draws (phlebotomy).
Privacy Practices and Personal. Your Rights. Our Responsibilities.
This Notice of Privacy Practices (“Notice”) describes how health information about you may be used and disclosed and how you can get access to this information and what your rights are with Our sharing Your health information.
Our Responsibilities. Notice of Privacy Practices
We are required by law to provide You with this Notice and Our legal duties and privacy practices with respect to your personal health information. You can ask for a paper copy of this Notice even if you have agreed to receive the Notice electronically.
Your rights
When it comes to your personal health information (“PHI”), you have certain rights. This notice explains your rights and some of our responsibilities.
Obtain an electronic or paper copy of your health record
You may ask to review your health record or You may request a copy of it. Ask Us how to do this.
We will provide a copy or a summary of your health information, within 30 days of your request. We may charge a reasonable, cost-based fee.
Request confidential communications
Ask us to correct your health record or limit what We share.
You can ask us to correct health information about what you think is incorrect or incomplete. We may say “No” to your request, but we’ll tell you why in writing within 60 days.
You can ask us not to use or share certain health information for treatment or payment. We are not required to agree to your request, and may say “No” if it would affect your care.
Your choices
By signing this Notice, you agree that We may share your personal health information with other professionals to provide, coordinate, or manage your health care and related services and any payers who may pay or reimburse for Our services.
By signing this Notice, you agree that we can use and share your health information to run Beauty Rehab, improve your care, and contact you when necessary.
Permission and Requirements to Disclose
Client Financial Responsibility and Cancellation, and No-Show Policies.
1. Itemized Charges. Nursing Aesthetic Services (“Services”) provided to You under this Agreement are charged on a fee-for-service basis (“Itemized Charges”). In exchange for a Service, You agree to pay Us the Itemized Charge for the Service that is in effect at the time when You receive the Service. We reserve the right to change the fees of Our Itemized Charges at any time. We cannot guarantee that you will be notified of any increased Itemized Charge for a Service before You receive the Service.
2. Cash Based. We are fully cash-based and only accept cash (in various forms, including credit/debit cards) for Services that we provide. Beauty Rehab does not make any representations regarding third-party insurance reimbursement of fees paid under this Agreement, and such reimbursement is not anticipated by the Agreement.
3. Full Payment Required for Services. Full payment for all Services provided is due at the time of Service. We do offer financial plans through Cherry.
4. No-Show/Cancellation Policies. We kindly request that you give us a minimum of 48 hours ' notice if you need to cancel an appointment. If You do not arrive to an appointment, or you cancel Your appointment with less than 48 hours-notice these appointments will be regarded as “No-Show” appointments and you will be charged a non-refundable $150 fee. After the 2nd No-Show Appointment, We may dismiss You from receiving any additional Services from Beauty Rehab.
5. Late Arrival. If You are more than 10 minutes late for a scheduled appointment, We may reschedule your appointment. If You are consistently late for appointments (more than 3 times) We may dismiss You from receiving any additional Services from Beauty Rehab.
6. Storing Your Financial Information. We do store your credit or debit card on file. Each time You receive a Service, You will need to provide Us with your credit or debit card information.
Miscellaneous.
7. Amendment. No amendment or variation of the terms of this Agreement will be valid unless in writing and signed by Beauty Rehab and You.
8. Non-discrimination. Under no circumstances will Beauty Rehab discriminate against You, or terminate this Agreement based on sex, race, color, religion, ancestry, national origin, disability, medical condition, genetic information, marital status, sexual orientation, citizenship, primary language, immigration status, or any other protected status. However, Beauty Rehab reserves the right to accept or decline clients based upon our professional judgment about whether we can appropriately manage a Service that you request.
Please be advised that Beauty Rehab strictly adheres to all Colorado state and federal regulations regarding aesthetic services and the delegation of medical treatments. Colorado’s House Bill 25-1024 (HB25-1024), signed into law on April 7, 2025. Services performed by estheticians at Beauty Rehab are carried out under the delegation and supervision of Andrea Uliano, APRN, who also serves as the owner of the practice. In accordance with Colorado law, non-medical personnel such as estheticians are not permitted to perform certain procedures unless specifically delegated and supervised by a licensed Nurse Practitioner (NP). Beauty Rehab ensures full compliance with these legal requirements, and clients should be informed that some treatments may be provided by non-medical staff under appropriate oversight.
Nursing Director and Delegatee:
Andrea Uliano, Board-Certified Nurse Practitioner APN.1001055-NP
To File a grievance with the state: https://dora.colorado.gov/file-complaint
CLIENT ACKNOWLEDGEMENTS
You acknowledge that you have been given the opportunity to ask questions about this Agreement and all of your questions have been answered.